Use of Embolic Capture Angioplasty for the Treatment of Occluded Superficial Femoral Artery Segments
- Tue, 10/25/11 - 2:09pm
- 0 Comments
- 1392 reads
Abstract: Treatment of peripheral chronic total occlusion (CTO) is one of the most challenging lesion subsets in peripheral revascularization. Advanced wire technology, novel re-entry catheters and imaging techniques help in crossing such lesions. Subintimal dissection using blunt microdissection devices along with true lumen re-entry techniques have added to the success rates of treating peripheral CTOs.
Transradial Percutaneous Coronary Intervention in Patients Requiring Circulatory Assist Devices
- Tue, 10/25/11 - 1:07pm
- 0 Comments
- 869 reads
Transradial access for diagnostic and interventional procedures has been gaining acceptance in the United States.1 Advantages of transradial percutaneous coronary intervention (PCI) include improved patient satisfaction and potential decrease in costs related to early discharge.2-4 Perhaps the greatest advantage of this access strategy is a decrease in vascular complications.1,3-6
Subacute Stent Thrombosis Owing to Complete Clopidogrel Resistance Successfully Managed with Prasugrel
- Wed, 6/29/11 - 10:10am
- 1 Comments
- 4510 reads
ABSTRACT: This report describes a case of an acute anterior myocardial infarction secondary to subacute stent thrombosis of a drug-eluting stent within the proximal segment of the left anterior descending artery (LAD) 5 days after percutaneous transluminal coronary angioplasty and stenting (PCI). The patient was initially managed with conventional dual-antiplatelet therapy (aspirin and clopidogrel) and was subsequently found to have complete absence of adenosine diphosphate (ADP) receptor P2Y12 receptor inhibition.
Improvement in Hemodynamics with a New, Larger-Volume (50 cc) Intra-Aortic Balloon for High-Risk Percutaneous Coronary Intervention
- Tue, 3/29/11 - 9:57pm
- 0 Comments
- 3215 reads
ABSTRACT: A primary cause of adverse outcomes among high-risk patients undergoing percutaneous coronary intervention (PCI) may be a diminished capacity to tolerate the hemodynamic and ischemic insults that can occur during the procedure. A common means of mechanical support during PCI has been the intra-aortic balloon pump (IABP). We describe successful periprocedural mechanical support with a new, 50 cc IABP in a patient with both severe left ventricular dysfunction and extensive coronary arteriosclerosis, for whom PCI with stenting was indicated.
Intravascular Ultrasound-Guided True Lumen Re-entry for Successful Recanalization of Chronic Total Occlusions
- Wed, 12/22/10 - 1:45am
- 0 Comments
- 1991 reads
ABSTRACT: We report a strategy of intravascular ultrasound-guided selection of the true lumen entry site from the subintimal space for predictable and successful re-entry, critical to successful recanalization of coronary chronic total occlusions.
PressureWire for Comprehensive Hemodynamic Assessment in a Patient with Mechanical Aortic and Mitral Valves
- Fri, 10/29/10 - 8:52am
- 0 Comments
- 1496 reads
ABSTRACT: This is a case of a 65-year-old male with history of double mechanical valve implantation (aortic and mitral) who presented with symptoms of severe volume overload either related to cardiac disease or underlying cirrhosis. The precise etiology could not be determined by clinical examination and noninvasive diagnostic tests.
The GuideLiner “Child” Catheter for Percutaneous Coronary Intervention — Early Clinical Experience
- Fri, 10/8/10 - 10:16am
- 0 Comments
- 5633 reads
ABSTRACT: The failure to deliver a stent across the target lesion during percutaneous coronary intervention, especially in arteries with calcified tortuous anatomy, is often due to insufficient back-up support from the guiding catheter. Deep-vessel intubation with the guiding catheter may overcome this problem, but risks coronary dissection. The Heartrail II (Terumo, Japan) “five–in-six catheter system” (or “mother-and-child” catheter) comprises a flexible-tipped long 5 Fr catheter advanced through a standard 6 Fr guiding catheter to deeply intubate the target vessel, thus providing enough back-up support to enable stent delivery. Here we describe a newly developed “child” support catheter (The GuideLiner; Vascular Solutions, Inc., Minneapolis, Minnesota), report its successful use in a series of 4 difficult cases and discuss practical tips to optimize its performance.
Ventricular Pacing Redundancy to Prevent Loss of Capture: A Fail-safe for Pacemaker-Dependent Patients
- Fri, 5/7/10 - 9:44am
- 0 Comments
- 3432 reads
ABSTRACT: Background. Patients who are entirely dependent on ventricular pacing are typically at the mercy of a single ventricular lead and pacemaker output in order to provide physiologic support. This study presents a number of high-risk cases (two of which previously exhibited failure with standard pacing) in which ventricular pacing redundancy (VPR) was utilized in order to provide additional backup. VPR was achieved using a variety of configurations, all of which employed a second ventricular lead and the potential for additional ventricular pacing. Seven cases are presented in whi
Management of Radial and Brachial Artery Perforations during Transradial Procedures — A Practical Approach
- Fri, 10/9/09 - 9:11am
- 0 Comments
- 3853 reads
ABSTRACT: We present a practical approach to the management of iatrogenic radial and brachial artery perforations during transradial catheterization and interventions. These perforations were treated successfully without abandoning the procedure in 15 patients.
J INVASIVE CARDIOL 2009;21:544–547
Key words: radial artery perforation, PCI, guidewire,
coronary catheter, transradial approach
Transradial access to percutaneous diagnostic procedures was first reported by Campeau.1 Kiemeneij et al performed the first interventional procedure using this route.2 A negligible access-site com
The Confluent Balloon Technique–Two Cases Illustrating a Novel Method to Achieve Rapid Wire Crossing of Chronic Total Occlusion
- Fri, 10/9/09 - 9:05am
- 0 Comments
- 2892 reads
The Confluent Balloon Technique – Two Cases Illustrating a Novel Method to Achieve Rapid Wire Crossing of Chronic Total Occlusion during Retrograde Approach Percutaneous Coronary Intervention
ABSTRACT: We describe two cases of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery in which we were initially unable to achieve wire crossing. A novel technique of pushing both antegrade and retrograde balloons into the CTO lesion so that the balloons overlapped each other during inflation created a new confluent subintimal space allowing easy, relia
